<font color="#000000" face="Times New Roman" size="3">

</font><h1 style="margin: 0in 0in 0pt; line-height: 150%;"><b><u><span lang="PT-BR" style='line-height: 150%; font-family: "Verdana",sans-serif; font-size: 11pt; mso-bidi-font-size: 10.0pt;'><font color="#000000">SAMPLE
DATA</font></span></u></b></h1><font color="#000000" face="Times New Roman" size="3">

</font><h1 style="margin: 0in 0in 0pt; line-height: 150%;"><span lang="PT-BR" style='line-height: 150%; font-family: "Verdana",sans-serif; font-size: 11pt; mso-bidi-font-size: 10.0pt;'><font color="#000000">&nbsp;</font></span></h1><font color="#000000" face="Times New Roman" size="3">

</font><h1 style="margin: 0in 0in 0pt; line-height: 150%;"><span lang="PT-BR" style='line-height: 150%; font-family: "Verdana",sans-serif; font-size: 11pt; mso-bidi-font-size: 10.0pt;'><font color="#000000">&nbsp;</font></span></h1><font color="#000000" face="Times New Roman" size="3">

</font><h1 style="margin: 0in 0in 0pt; line-height: 150%;"><span lang="PT-BR" style='line-height: 150%; font-family: "Verdana",sans-serif; font-size: 11pt; mso-bidi-font-size: 10.0pt;'><font color="#000000">Processo
n.º </font></span></h1><font color="#000000" face="Times New Roman" size="3">

</font><p style="margin: 0in 0in 0pt; line-height: 150%;"><span lang="PT-BR" style='line-height: 150%; font-family: "Verdana",sans-serif; font-size: 11pt; mso-bidi-font-size: 12.0pt;'><font color="#000000">Denúncia:<b style="mso-bidi-font-weight: normal;"> <span style="mso-bidi-font-weight: bold;">SUSPENSÃO
CONTRATUAL - DOENÇA OU LESÃO PREEXISTENTE</span></b></font></span></p><font color="#000000" face="Times New Roman" size="3">

</font><p style="margin: 0in 0in 0pt; line-height: 150%;"><span lang="PT-BR" style='line-height: 150%; font-family: "Verdana",sans-serif; font-size: 11pt; mso-bidi-font-size: 12.0pt;'><font color="#000000">Operadora:
</font></span></p><font color="#000000" face="Times New Roman" size="3">

</font><p style="margin: 0in 0in 0pt; line-height: 150%;"><span lang="PT-BR" style='line-height: 150%; font-family: "Verdana",sans-serif; font-size: 11pt; mso-bidi-font-size: 12.0pt;'><font color="#000000">Auto
de Infração:<b style="mso-bidi-font-weight: normal;"> 21.261<span style="mso-spacerun: yes;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></b></font><font color="#000000">Emitido em:</font><b style="mso-bidi-font-weight: normal;"><font color="#000000"> 23/01/2007</font></b></span></p><font color="#000000" face="Times New Roman" size="3">

</font><p style="margin: 0in 0in 0pt; line-height: 150%; text-indent: 56.7pt;"><span lang="PT-BR" style='line-height: 150%; font-family: "Verdana",sans-serif; font-size: 11pt; mso-bidi-font-size: 12.0pt;'><font color="#000000">&nbsp;</font></span></p><font color="#000000" face="Times New Roman" size="3">

</font><h2 style="margin: 0in 0in 0pt; line-height: 150%;"><b style="mso-bidi-font-weight: normal;"><span lang="PT-BR" style='line-height: 150%; font-family: "Verdana",sans-serif; font-size: 11pt; mso-bidi-font-size: 10.0pt; mso-bidi-font-family: Arial;'><u><font color="#000000">RELATÓRIO</font></u></span></b></h2><font color="#000000" face="Times New Roman" size="3">

</font><p style="margin: 0in 0in 0pt; text-align: justify; line-height: 150%;"><b style="mso-bidi-font-weight: normal;"><span lang="PT-BR" style='line-height: 150%; font-family: "Verdana",sans-serif; font-size: 11pt; mso-bidi-font-size: 12.0pt; mso-bidi-font-family: Arial;'><font color="#000000">&nbsp;</font></span></b></p><font color="#000000" face="Times New Roman" size="3">

</font><p style="margin: 0in 0in 0pt; text-align: justify; line-height: 150%;"><b style="mso-bidi-font-weight: normal;"><span lang="PT-BR" style='line-height: 150%; font-family: "Verdana",sans-serif; font-size: 11pt; mso-bidi-font-size: 12.0pt; mso-bidi-font-family: Arial;'><font color="#000000">&nbsp;</font></span></b></p><font color="#000000" face="Times New Roman" size="3">

</font><p style="margin: 0in 0in 0pt; line-height: 150%; text-indent: 42.55pt;"><span lang="PT-BR" style='line-height: 150%; font-family: "Verdana",sans-serif; font-size: 11pt; mso-bidi-font-size: 10.0pt; mso-bidi-font-family: Arial;'><font color="#000000">Trata-se de
processo administrativo que se originou de denúncia dirigida a esta., em face
da operadora </font></span><b><span lang="PT-BR" style='color: black; line-height: 150%; font-family: "Verdana",sans-serif; font-size: 11pt; mso-bidi-font-size: 8.5pt;'>XXXXX</span></b><span lang="PT-BR" style='line-height: 150%; font-family: "Verdana",sans-serif; font-size: 11pt; mso-bidi-font-size: 10.0pt; mso-bidi-font-family: Arial;'><font color="#000000">, inscrita no CNPJ
sob o n.º </font></span><span lang="PT-BR" style='color: black; line-height: 150%; font-family: "Verdana",sans-serif; font-size: 11pt; mso-bidi-font-size: 8.5pt;'>03.005.217/0001-82</span><span lang="PT-BR" style='line-height: 150%; font-family: "Verdana",sans-serif; font-size: 11pt; mso-bidi-font-size: 10.0pt; mso-bidi-font-family: Arial;'><font color="#000000">, por não garantir
a cobertura a cirurgia relativa à Síndrome do Túnel do Carpo (tendinite), sob
alegação de doença ou lesão preexistente (DLP).</font></span></p><font color="#000000" face="Times New Roman" size="3">

</font><p style="margin: 0in 0in 0pt; line-height: 150%; text-indent: 42.55pt;"><span lang="PT-BR" style='line-height: 150%; font-family: "Verdana",sans-serif; font-size: 11pt; mso-bidi-font-size: 10.0pt; mso-bidi-font-family: Arial;'><font color="#000000">&nbsp;</font></span></p><font color="#000000" face="Times New Roman" size="3">

</font><p style="margin: 0in 0in 0pt; line-height: 150%; text-indent: 42.55pt;"><span lang="PT-BR" style='color: black; line-height: 150%; font-family: "Verdana",sans-serif; font-size: 11pt; mso-bidi-font-size: 8.5pt;'>Nos autos do processo
administrativo a operadora autuada alegou, em sua manifestação, à fl.09, que
não procedeu à devida cobertura tendo em vista tratar-se de uma DLP, estando
então, afastada a cobertura dos eventos abarcados pela Cobertura Parcial
temporária – CPT.<span style="mso-spacerun: yes;">&nbsp; </span>Não comprovou nos
autos, porém, o oferecimento dessa opção e nem mesmo de comprovação de tal DLP
antes da negativa de procedimento.</span></p><font color="#000000" face="Times New Roman" size="3">

</font><p style="margin: 0in 0in 0pt; line-height: 150%; text-indent: 42.55pt;"><span lang="PT-BR" style='line-height: 150%; font-family: "Verdana",sans-serif; font-size: 11pt; mso-bidi-font-size: 10.0pt; mso-bidi-font-family: Arial;'><font color="#000000">&nbsp;</font></span></p><font color="#000000" face="Times New Roman" size="3">

</font><p style="margin: 0in 0in 0pt; line-height: 150%; text-indent: 42.55pt;"><font color="#000000"><span lang="PT-BR" style='line-height: 150%; font-family: "Verdana",sans-serif; font-size: 11pt; mso-bidi-font-size: 10.0pt;'>Conseqüentemente,</span><span lang="PT-BR" style='line-height: 150%; font-family: "Verdana",sans-serif; font-size: 11pt; mso-bidi-font-size: 10.0pt; mso-bidi-font-family: Arial;'> oà fl. 25, lavrou o auto de
infração nº, posteriormente considerado nulo, sendo então lavrado, à fl.118, o
auto nº, em 23.01.2007, </span><span lang="PT-BR" style='line-height: 150%; font-family: "Verdana",sans-serif; font-size: 11pt; mso-bidi-font-size: 10.0pt;'>pela
infração ao<span style="mso-bidi-font-style: italic;"> </span><i style="mso-bidi-font-style: normal;">“artigo 11, Parágrafo Único da Lei 9656/98,
pela constatação da conduta prevista no Artigo 7º, inciso I, da RDC 24/2000,
por suspender a assistência à saúde, ao negar cobertura, em agosto/2001, a
procedimento cirúrgico para correção de Síndrome do Túnel do carpo a M.L.M.S.,
contrato individual/familiar firmado em 27/5/2000, sob alegação de doença
preexistente e sem autorização da ANS.”</i></span><span lang="PT-BR" style='line-height: 150%; font-family: "Verdana",sans-serif; font-size: 11pt; mso-bidi-font-size: 10.0pt; mso-bidi-font-family: Arial;'>.</span></font></p><font color="#000000" face="Times New Roman" size="3">

</font><p style="margin: 0in 0in 0pt; line-height: 150%; text-indent: 42.55pt;"><span lang="PT-BR" style='line-height: 150%; font-family: "Verdana",sans-serif; font-size: 11pt; mso-bidi-font-size: 10.0pt; mso-bidi-font-family: Arial;'><font color="#000000">&nbsp;</font></span></p><font color="#000000" face="Times New Roman" size="3">

</font><p style="margin: 0in 0in 0pt; line-height: 150%; text-indent: 42.55pt;"><span lang="PT-BR" style='line-height: 150%; font-family: "Verdana",sans-serif; font-size: 11pt; mso-bidi-font-size: 10.0pt; mso-bidi-font-family: Arial;'><font color="#000000">Notificada sobre o
auto (fls. 117), a demandada apresentou defesa às fls. 120 a 129. Alegou, em
síntese:</font></span></p><font color="#000000" face="Times New Roman" size="3">

</font><p style="margin: 0in 0in 0pt; line-height: 150%; text-indent: 42.55pt;"><span lang="PT-BR" style='line-height: 150%; font-family: "Verdana",sans-serif; font-size: 11pt; mso-bidi-font-size: 10.0pt; mso-bidi-font-family: Arial;'><font color="#000000">&nbsp;</font></span></p><font color="#000000" face="Times New Roman" size="3">

</font><ul style="list-style-type: disc; direction: ltr;"><li style="font-weight: normal;"><p style="line-height: 150%; font-weight: normal; margin-top: 0in; margin-bottom: 0pt; mso-list: l0 level1 lfo1; tab-stops: list 99.55pt;"><span lang="PT-BR" style='line-height: 150%; font-family: "Verdana",sans-serif; font-size: 11pt; mso-bidi-font-size: 10.0pt; mso-bidi-font-family: Arial;'>A infração restou impossibilitada de ser sancionada
tendo em vista a prescrição trienal ocorrida;</span></p></li><li style='color: rgb(0, 0, 0); font-family: "Verdana",sans-serif; font-size: 11pt; font-weight: normal;'><p style='color: rgb(0, 0, 0); line-height: 150%; font-family: "Times New Roman",serif; font-size: 14pt; font-weight: normal; margin-top: 0in; margin-bottom: 0pt; mso-list: l0 level1 lfo1; tab-stops: list 99.55pt;'><span lang="PT-BR" style='line-height: 150%; font-family: "Verdana",sans-serif; font-size: 11pt; mso-bidi-font-size: 10.0pt; mso-bidi-font-family: Arial;'>A empresa, durante o aguardo do julgamento de
recurso administrativo relativo ao Auto de infração que fora considerado nulo,
realizou o procedimento cirúrgico que dera origem à autuação inicial;</span></p></li><li style='color: rgb(0, 0, 0); font-family: "Verdana",sans-serif; font-size: 11pt; font-weight: normal;'><p style='color: rgb(0, 0, 0); line-height: 150%; font-family: "Times New Roman",serif; font-size: 14pt; font-weight: normal; margin-top: 0in; margin-bottom: 0pt; mso-list: l0 level1 lfo1; tab-stops: list 99.55pt;'><span lang="PT-BR" style='line-height: 150%; font-family: "Verdana",sans-serif; font-size: 11pt; mso-bidi-font-size: 10.0pt; mso-bidi-font-family: Arial;'>Assim teria se dado a reparação voluntária e
eficaz, de acordo com os termos da RN nº142/06; e</span></p></li><li style='color: rgb(0, 0, 0); font-family: "Verdana",sans-serif; font-size: 11pt; font-weight: normal;'><p style='color: rgb(0, 0, 0); line-height: 150%; font-family: "Times New Roman",serif; font-size: 14pt; font-weight: normal; margin-top: 0in; margin-bottom: 0pt; mso-list: l0 level1 lfo1; tab-stops: list 99.55pt;'><span lang="PT-BR" style='line-height: 150%; font-family: "Verdana",sans-serif; font-size: 11pt; mso-bidi-font-size: 10.0pt; mso-bidi-font-family: Arial;'>Não desobedecera a legislação já que a vedação
desta é de suspensão do atendimento até a prova da fraude, que se deu nos autos,
pela impossibilidade de evolução da doença no período de 12 meses. Deduziu-se,
por exame médico, que quando da contratação a beneficiária já apresentava a
patologia.</span></p><p style='color: rgb(0, 0, 0); line-height: 150%; font-family: "Times New Roman",serif; font-size: 14pt; font-weight: normal; margin-top: 0in; margin-bottom: 0pt;'><span lang="PT-BR" style='line-height: 150%; font-family: "Verdana",sans-serif; font-size: 11pt; mso-bidi-font-size: 10.0pt; mso-bidi-font-family: Arial;'>&nbsp;</span></p></li></ul><font color="#000000" face="Times New Roman" size="3">









</font><p style="margin: 0in 0in 0pt;"><span lang="PT-BR" style='font-family: "Verdana",sans-serif; font-size: 11pt; mso-bidi-font-size: 12.0pt; mso-bidi-font-family: Arial;'><font color="#000000">É o
relatório.</font></span></p><font color="#000000" face="Times New Roman" size="3">

</font><p style="margin: 0in 0in 0pt;"><span lang="PT-BR" style='font-family: "Verdana",sans-serif; font-size: 11pt; mso-bidi-font-size: 12.0pt; mso-bidi-font-family: Arial;'><font color="#000000">&nbsp;</font></span></p><font color="#000000" face="Times New Roman" size="3">

</font><p style="margin: 0in 0in 0pt;"><span lang="PT-BR" style='font-family: "Verdana",sans-serif; font-size: 11pt; mso-bidi-font-size: 12.0pt; mso-bidi-font-family: Arial;'><font color="#000000">&nbsp;</font></span></p><font color="#000000" face="Times New Roman" size="3">

</font><p style="margin: 0in 0in 0pt;"><span lang="PT-BR" style='font-family: "Verdana",sans-serif; font-size: 11pt; mso-bidi-font-size: 12.0pt; mso-bidi-font-family: Arial;'><font color="#000000">&nbsp;</font></span></p><font color="#000000" face="Times New Roman" size="3">

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</font><h1 style="margin: 0in 0in 0pt; line-height: 150%;"><b><u><span lang="PT-BR" style='line-height: 150%; font-family: "Verdana",sans-serif; font-size: 11pt; mso-bidi-font-size: 10.0pt;'><font color="#000000">SCREENSHOT</font></span></u></b></h1><font color="#000000" face="Times New Roman" size="3">

</font><p style="margin: 0in 0in 0pt;"><strong><span lang="EN" style="mso-ansi-language: EN;"><font color="#000000" face="Times New Roman" size="3">&nbsp;</font></span></strong></p><font color="#000000" face="Times New Roman" size="3">

</font><p style="margin: 0in 0in 0pt;"><strong><span lang="EN" style="mso-ansi-language: EN;"><font color="#000000" face="Times New Roman" size="3"><img width="589" height="442" src="" v:shapes="_x0000_i1025"></font></span></strong></p><font color="#000000" face="Times New Roman" size="3">

</font><p style="margin: 0in 0in 0pt;"><strong><span lang="EN" style="mso-ansi-language: EN;"><font color="#000000" face="Times New Roman" size="3">&nbsp;</font></span></strong></p><font color="#000000" face="Times New Roman" size="3">

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